MEDICARE: NATIONAL VISION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician

General Provider Information

NPI Number	:	1952772402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL VISION, INC.

Provider Business Mailing Address
First Line	:	2435 COMMERCE AVE
Second Line	:	BLDG 2200
City	:	DULUTH
State	:	GA
Zip	:	30096-4980
Country	:	US
Telephone Number	:	800-571-5202
Fax Number	:

Provider Business Practice Location Address
First Line	:	2780 S COLORADO BLVD
Second Line	:	STE 300
City	:	DENVER
State	:	CO
Zip	:	80222-6629
Country	:	US
Telephone Number	:	303-256-6820
Fax Number	:	303-753-7586

Authorized Official
Title or Position	:	MANAGED CARE SALES COORDINATOR
Name	:	LEAHANN VAUGHN
Credential	:
Telephone Number	:	470-448-2782

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	10/09/2015

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Directions to “NATIONAL VISION, INC. ” Practice Location

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